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Doubtless there were concealed cases—twenty-four, supposing the
rate of mortality in home treated cases to have been the same as
in hospital cases.
In respect of number of persons attacked, 1881 was the worst
year since 1871, when there were 444 recorded cases, viz., 303
north, and 141 south, of Oxbridge Road: the deaths in 1871
were 120, viz., 58 in hospitals out of 301 cases (=18.8 per cent.)
and 62 at home out of 143 known cases (=43.3 per cent.)
Assuming an equal rate of mortality in home and hospital cases, some
186 attacks must have been concealed, or nearly 30 per cent. of
total cases, the proportionate percentage of concealed cases in
1881 being under seven.
Judged by the rate of mortality 1877 was a worse year than
1881, for there were 84 deaths out of 359 cases, viz., 60 deaths
out of 255 cases in hospital (=23.5 per cent.), and 24 deaths out or
104 home treated cases (=23 per cent.), therate of mortality therefore
in home and hospital cases being practically identical: but as I
cannot suppose there were no concealed cases, it would appear that
the mortality must have been somewhat less in home treated cases
than in the hospital cases. The concealed cases no doubt were
mild whether many or few:—by concealed cases I here mean cases
that never came to light; many fatal cases had, in another sense,
been "concealed," viz., until the existence of the disease was
revealed on the registration of death.
On a comparison of the three years 1871,1877, and 1881, we
may conclude I think that, as time has rolled on, there has been a
growing disposition to notify the occurrence of small-pox; an
increased willingness to permit the removal of patients to hospital,
and a lowered rate of mortality. The rate of mortality in 1871
was 27'2 per cent. on attacks, in 1877 26.1 per cent., in 1881
14.9 per cent. The mortality in hospital cases in 1871,1877, and
1881 respectively, was 18.8, 23.5, and 14'0 per cent. Of the known
cases 67.7 per cent. Avere removed to hospital in 1871; 71 per
cent. in 1877; and 81.3 per cent. in 1881. It will be remembered
that in 1877 Fulham Hospital was opened, and it is not too much
to say that, owing to its proximity to the parish, we have been
more successful in getting patients to go to hospital than in 1871,
when the bulk of our cases were sent to Hampstead. It is a fact
doubtless, that people are more willing to let their sick go to